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Appendix VIII <br /> Underground Storage Tank <br /> Spill Container Testing Report Farm <br /> TYPE OF ACTION Ll Installation LJ Repair R) 12 Month <br /> F1. FACILITY INFORMATION <br /> CE RS ID Test Date <br /> 10165815 09/08/2022 <br /> Facility Name <br /> 7-ELEVEN#17334 MKT 2368(N-747) <br /> Facility Address city ZIP Code <br /> 4501 N.PERSHING AVE.@ ROSEMARIE LN. STOCKTON 95207 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing the Test Phone <br /> Tanknology,Inc. 800-964-1250 <br /> Mailing Address <br /> 11000 N Mopac Expy#500 Austin,TX 78759 <br /> Service Technician Performing Test <br /> Landon Zamora <br /> ContractorlTank Tester License Number <br /> 743160 <br /> ICC Number ICC Expiration Date <br /> 9768392 06/08/2023 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> Veeder Root:ATG Technician 04/27/2023 <br /> OPW:EVR Phase 1 02/24/2024 <br /> PEI:RP 1200 06/05/2079 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tested <br /> INDUSTRY STANDARD SB <br /> 5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> I hereby certify that each spill container was tested in accordance with California Code of <br /> Regulations, title 23, division 3, chapter 46, section 2637.1. that required supporring <br /> documentation is artached; and all information contained herein is accurate. 1 understand <br /> that tesr procedures shall be made available upon request by the governing authority. <br /> Service Technician Signatu:-e Date Total # of Pages <br /> 09/08/2022 2 <br /> CERS = California Environmental Reporting System, D = Identification, ICC = Intemational Code <br /> Council <br /> Page 1 of 2 <br />